UNC's empirical research ethics in Malawi

Using Analogy to Explain Research Methods to Non-Scientists

There is a growing acknowledgment that the quality of the informed consent may depend on how the information about a study is conveyed to the prospective participants. Part of the problem is that the way the information is communicated or the concepts included in the consent process may be foreign and difficult to grasp. While this is not specifically a problem with research participation in the developing world -- studies have shown similar issues in US and European contexts -- studies conducted in resource-poor settings, with illiterate or semi-literate populations and who may have little experience with 'Western' scientific concepts pose additional challenges.

For the above reasons, alternative approaches to informed consent processes are being explored. One approach that has been suggested for explaining what may be hard-to-understand scientific methods is to use a “bottom up” analogy, based on subjects’ experience, presented in pictures, and discussed in culturally relevant terms. The approach capitalizes on the idea that new knowledge is meaningful when related to existing knowledge. For example, people in agrarian cultures may better understand the logic of random assignment if it is first explained in the context of trying out whether a fertilizer (versus no fertilizer) improves a crop of corn. Once this familiar concept is discussed and understood, the analogy to random assignment of human subjects in clinical research can be explained and discussed with careful attention to dispelling semantic confusion.

Corneli, et al. describe how such explanatory material was developed and assembled into pictorial counseling cards which can be presented to potential research subjects. Some of the figures from the study, are available at the links below (used by permission from the Journal of Empirical Research on Human Research Ethics)

• Figure 3: A description of medical research using pictures and analogy

• Figure 4: How formative data impacted on the explanation of randomization in the study

• Figure 5: The developmental process for drawings used with the counseling cards

To learn more about this approach, and ways in which it might be generalized for communicating effectively with research subjects in other situations, you will want to read their article:

Corneli, A., et al (2006). Using formative research to develop a context-specific approach to informed consent for clinical trials. Journal of Empirical Research on Human Research Ethics, 1(4), 45-60. (Subscription required)